de Souza, Ramon Andrade; Barreto, Florisneide Rodrigues; de Jesus Lima, Carla Cristina Oliveira; da Natividade, Marcio Santos; de Souza Teles Santos, Carlos Antônio; Ichihara, Maria Yury; Pereira, Marcos; de Castro, Daniel Barros; Genser, Bernd; Rodrigues, Laura Cunha; +2 more... Barreto, Maurício Lima; Pereira, Susan Martins; (2025) Efficacy of BCG vaccination on incidence, severity and clinical progression of COVID-19: A BCG-REVAC population analysis. Vaccine, 54. ISSN 0264-410X DOI: https://doi.org/10.1016/j.vaccine.2025.126911
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Abstract
BACKGROUND: Can vaccination with Bacille Calmette-Guérin prevent clinical progression of COVID-19? Data from the BCG-REVAC trial was archived in a database, creating an excellent opportunity to link it to notified cases of COVID-19 to evaluate the efficacy of BCG against incidence, severity and clinical progression to severe COVID-19 when given at birth day, at school age as a first dose or as a second dose. METHODS: This study was conducted in the population of the BCG-REVAC cluster randomisation trial including 354,403 schoolchildren, aged 7 to 14 years, from 767 schools from two cities, Salvador and Manaus. Cases of COVID-19 from the System for Notification of Infectious Diseases and the System for Notification of Severe Respiratory Illnesses were record linked to BCG-REVAC population. The exposure was Vaccination or revaccination obtained by the BCG-REVAC. The outcomes of interest in this study were incidence COVID-19; incidence of severe COVID-19; and clinical progression of COVID-19. This project was approved by the Ethics Committee of the Institute of Collective Health, Federal University of Bahia, Brazil. RESULTS: The neonatal dose and a first dose of BCG at school age protect against the incidence of severe COVID-19 in multivariate models, whose efficacies were 30 % (95 %CI:1-51) and 64 % (95 %CI: 22-84), respectively. The neonatal dose showed an effect on severe clinical progression of symptomatic COVID-19 disease in COVID-19 infected subjects 39 % (95 %CI:11 % - 58 %). CONCLUSION: Even 23 years after BCG vaccination and revaccination of school-age children our results suggesting a protective effect of BCG first dose against incidence of severe COVID-19 in infected individuals, a smaller effect of the neonatal dose and no effect of the second dose at school age.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) |
Elements ID | 238087 |
Official URL | https://doi.org/10.1016/j.vaccine.2025.126911 |
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